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Azulene is an aromatic organic compound and a structural isomer of naphthalene that is notable for its deep blue color[8]. It has been used in medicine primarily for its anti-inflammatory and soothing properties[4][5][1]. Azulene and its derivatives are found in nature (e.g., chamomile oil) and have a long history of use as chromophores in plant extracts[8]. In pharmaceutical applications, azulene acts as a non-steroidal anti-inflammatory agent with additional analgesic and antipyretic effects; it works mainly by inhibiting cyclooxygenase 2 enzymes (especially COX-2), thereby reducing prostaglandin synthesis involved in inflammation[4][5]. Azulene also stabilizes cell membranes and modulates cytokine secretion to further limit inflammatory responses[5]. Clinically or cosmetically it is used topically to soothe irritated or inflamed skin (as in creams/ointments) or ophthalmically to treat eye inflammation such as conjunctivitis or keratitis[1][7]. Various azulene derivatives are under investigation for broader therapeutic uses including peptic ulcer disease, leukemia (via Fms-like tyrosine kinase 3 inhibition), diabetes mellitus complications, HIV infection (antiretroviral activity), antimicrobial photodynamic therapy, antifungal therapy, and erectile dysfunction through different mechanisms involving tyrosine kinase inhibition or receptor modulation[3][5]. Azulene itself serves more often as a scaffold for drug development than as an active pharmaceutical ingredient; many marketed products contain azulene derivatives rather than pure azulene. Its most established clinical use is topical/ophthalmic anti-inflammation.
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